Many Complications to Pharmaceutical Treatment

When Susan, a 56-year old, advertising executive began experiencing pain in the back of her heel, she immediately attributed it to her new exercise regimen. Surprising, since it only consisted of walking farther, and more often. She wasn’t yet doing any treadmill work, or the yoga she was hoping to return to. Her fitness plan was largely due to the weight gain she had experienced over the last years, which had been steady, and quite disconcerting. Yet, over-all, her health was good. She did have a urinary tract infection some months ago, which had dragged on for weeks before an antibiotic knocked it out.

Susan promptly cut back on her walking routine, as well as doing some home therapies, but rather than subside, her symptoms increased. Irritating as this was, serious concern developed only when she felt a sudden and obvious sensation in the back of her ankle while going up the stairs in her house. She likened the sensation to being hit with a bat. Every step thereafter was difficult, weakened, and vaguely painful. Clearly, something had occurred, and she now had a real problem.

Her primary care doctor diagnosed an Achilles tendon rupture, a rather unexpected conclusion given her lack of any intensive activities or sports. She was not a “weekend warrior”, so the reason for her condition was not clear. A referral to several other specialists did not elucidate the reason for this injury, until one research-minded physician discovered a connection between the tendon rupture she had suffered, and the antibiotics she had taken months previously. The drug was in the class of Quinolones, with Cipro, the drug she had taken, being the best known example.

Apparently, these antibiotics have the potential to cause various tendon problems, with a rupture being the most severe. Although the Achilles tendon is the most susceptible site, other tendons may be affected, including tendons in the shoulder, upper arm, and lower leg. Typically, spontaneous tendon rupture occurs during or shortly after a course of therapy, but symptoms may occur months after taking this type of antibiotic.

It can be difficult to prove cause-and-effect relationships involving medications and certain side effects. This is particularly true in untoward effects such as tendon ruptures, which may occur in the absence of any medication, particularly since the reported cases frequently had coexisting risk factors. However, clinical reports, microscopic studies, and various experiments support a relationship between the use of quinolones and tendon ruptures. It is not terribly common, but it has become clear there is an association.

One of the most commonly prescribed drugs for diabetes is metformin, a disease which frequently causes neuropathy, a problem with the nerves in the toes and feet. Although many are unaware, metformin is a known pharmacologic cause of Vitamin B12 deficiency. Low levels of this vitamin are a well-established cause of neuropathy. So, in other words, you are prescribed a drug to control the effects of a dangerous disease, with the drug itself causing the same complications that the disease does.

Of course, every drug has some kind of possible complication. Anti-inflammatory drugs cause stomach bleeds, many pain relievers produce excessive sedation, and then there is the overwhelming problem of addiction to pain relievers. Most people are aware that drugs have the potential to cause complications. Now that they are required to list those in advertisement, commercials for prescription drugs are scarier than a good horror movie. Still, so many problems that people present to their physicians with are treated by the prescribing of a drug. This is generally considered “conservative care”, since it is not surgery.

The U.S. Food and Drug Administration (FDA), which oversees all new drug applications, depends on clinical trials conducted by the drug companies to determine a drug’s therapeutic advantages and disadvantages. The FDA is supposed to only approve drugs that have greater benefits than dangers. Many wonder why medications that are considered dangerous are allowed on the market. The truth is that nearly all medications, both over-the-counter and prescription, have some undesirable and sometimes dangerous effects, from muscle aches to death. Even with the federal regulations that oversee these drugs, side effects are inevitable. For federal regulators, though, the idea is that, hopefully, the benefits outweigh the dangers.

Each year, about 4.5 million Americans visit their doctor’s office or the emergency room because of adverse prescription side effects. A startling 2 million other patients who are already hospitalized suffer the ill effects of prescription medications every year. Sixty-five percent of the country takes a prescription medication these days. Estimates vary, but some say 100,000 Americans die from complications associated with the use of a drug. But these deaths were from known side effects, and not because of a mistake in filling the prescription, or the use of the medication. If you dig a little, you find that reported reactions to pharmaceuticals only skim the surface. Drug side effects are not always recognized as such. Doctors often attribute them to other causes, people downplay them or do not report them at all.

The drug companies have made Americans believe that almost anything can and should be treated with a pill. Women can ask their doctors for a drug that will diminish their facial hair. Parents can ask for a stimulant to keep their children calm and focused. “Big Pharma” has discovered there are billions of dollars to be made by selling pills to Americans who worry about getting old. Many drugs are vastly over-prescribed and unnecessary.It would seem prudent to make sure that you treat the consumption of some drug as a last option, not a first choice. For example, many conditions can be treated or prevented with lifestyle changes. Yet if you go to a physician with early signs of some common disease, such as high blood pressure or diabetes, you will likely be prescribed a potentially dangerous drug instead of recommendations being made to alter your diet, fitness regimen, or some other healthy change.

Ultimately, it’s your body, and your decision what to put in it. If your doctor suggests you take a drug, do some research before you take it. But don’t wait until you’re sick or slowing down to make healthy changes. Do them NOW. Become an active participant in your health, and prevent completely the possibility of drug side effects by never having to take it in the first place. Now that’s good for your health!